| NPI | 1083021448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA OP61152499) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT16180) |
| 207P00000X Emergency Medicine (Licence: WA OP61152499) | |
| 207R00000X Internal Medicine (Licence: PA OT16180) | |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2021-11-24 |